INSTRUCTIONS FOR COMPLETING THIS FORM (Remove this page prior to completing form.)
Please print this form in English using blue or black ink, pressing firmly so all information transfers to all copies. Complete the
declaration fully and legibly; otherwise, delay and inconvenience may result for the addressee. A false or misleading declaration
may lead to a fine or seizure of the item and additional penalties. You may add a translation of the contents in a language
accepted in the destination country.
Your goods may be subject to restrictions. It is your responsibility to comply with import and export regulations and restrictions
(e.g., quarantine, pharmaceutical, etc.), and to determine what documents (e.g., commercial invoice, certificate of origin, health
certificate, license, authorization for goods subject to quarantine such as plant, animal, or food products, etc.), if any are required
in the destination country. Check the country listings at http://pe.usps.gov/, as well as the UPU List of Prohibited Items available
at http://www/upu.int/customs/en/country_list_en.pdf.
FROM (Sender information) and TO (Addressee information) sections: The sender’s and addressee’s full name and full address
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must be entered in the blocks provided on the 2976-A. Incomplete names (e.g., initials) or incomplete address entries on the
2976-A may result in delayed handling by Customs and/or the delivery office.
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Block 1: Enter a detailed description of each article - e.g., “men’s cotton shirts.” General descriptions - e.g., “samples”, “food
products” or “toiletries” - are not permitted. If there is insufficient space on the form to list all articles, use additional form(s) as
needed. Indicate on the first form (to the right of the barcode) the following: “Additional forms enclosed”. Important: Obliterate
the tracking number and barcode on subsequent form(s) and place all the form(s) into PS Form 2976-E (plastic envelope).
Block 2 - Block 4: Enter the quantity, net weight (in pounds and ounces) and value (in U.S. dollars) of each article.
Block 5: Check the box specifying the category of the item.
Block 6: Select mail handling method.
Block 7: Identify if special conditions or restrictions apply to items being mailed, if applicable.
Block 8: Enter the total weight of the package in pounds and ounces, including packaging, which corresponds to the weight used
to calculate the postage.
Block 9: Enter the total value in U.S. dollars.
Block 10: Check the box specifying instructions in case of nondelivery. Items returned to sender are subject to return charges at
the sender’s expense.
PS Form 2976-A, May 2009 PSN: 7530-01-000-9834 See reverse of this page for additional instructions on how to complete this form
Block 11: Except for shipments to APO/FPO/DPO addresses, enter an Exemption or Exclusion Legend (EEL) or a Proof of Filing
Citation (PFC). Either an EEL or PFC must be displayed in block 11 before a package is presented to the Postal Service for
mailing internationally or to an overseas U.S. Territory. In general, mailpieces containing any type of goods (per Schedule B
Export Codes at http://www.census.gov/foreign-trade/schedules/b) valued at more than $2,500 or requiring an export license
under U.S. law must have a Proof of Filing Citation (PFC) issued by the U.S. Census Bureau, subject to certain exceptions.
Mailpieces that are exempt from filing must have an EEL. Regardless of exemptions, all mailpieces must have a PFC if they are
destined for certain countries designated by the Department of State. To obtain a PFC and file electronically through the Census
Bureau’s Automated Export System (AES), or for additional information, please go to http://www.census.gov/foreign-trade/aes
or call 1-800-549-0595. Please also refer to US Postal Service Publication 613, U.S. Census Bureau Regulations, for additional
information.
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Block 12: Check the box if the contents are subject to quarantine restrictions (plant, animal, food products, etc.)
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Block 13: Sign and date the form. Your signature certifies that all entries are correct and the item(s) being mailed contains no
dangerous, prohibited, or restricted contents per postal, customs, or destination country regulations. Your signature also certifies
compliance with Foreign Trade Regulations and confirms your liability for the item(s) being mailed.
Block 14 - Block 15: Enter Sender’s Customs Reference and Importer’s Reference, if applicable (The Importer’s Reference might
be a tax code, importer code, or VAT number used for sales tax.)
Block 16: If known, please provide addressee’s telephone, email address or fax number, as this could be used to facilitate
customs clearance or delivery.
Block 17 - Block 21: Enter License, Certificate, and/or Invoice number, if applicable in Blocks 17-19. In Block 20, enter the 6-digit
HS tariff number (if known), which must be based on the Harmonized Commodity Description and Coding System developed by
the World Customs Organization. In Block 21, “Country of Origin” (if known) means the country where the goods originated - e.g.,
where produced/manufactured or assembled.
Insert the completed form(s) into PS Form 2976-E, Customs Declaration Envelope - CP 91. Enclose any commercial documents
into the envelope. Do not fold form set or wrap around the package. The entire barcode and all information must be visible.
Remove the backing sheet and affix the envelope to the package on the address side.
PS Form 2976-A, May 2009 PSN: 7530-01-000-9834 Reverse of instructions for completing form.
14. Sender’s Customs Reference (If any)
15. Importer’s Reference - Optional (If any)
16.
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17.
Sample
18.
19.
20. 21.
Gift Returned Goods
Documents Commercial Sample Airmail
Merchandise Other: Surface
11. EEL/PFC 12. Restrictions
Quarantine Sanitary or Phytosanitary Inspection
13. I certify the particulars given in this customs declaration are correct. This item does not contain any dangerous article,
or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements
under the Foreign Trade Regulations. Sender’s Signature and Date
PS Form 2976-A, May 2009 PSN: 7530-01-000-9834 1 - Manifesting/Scan Copy
United States Postal Service®
Customs Declaration and Dispatch Note — CP 72
IMPORTANT: This item may be opened officially. Please print in English, using blue or black ink, and press
firmly; you are making multiple copies. See Privacy Notice and Indemnity Coverage on Customer Copy.
14. Sender’s Customs Reference (If any)
15. Importer’s Reference - Optional (If any)
.
16. Importer's Telephone Fax Email (select one)
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17. License No.
Sample
18. Certificate No.
19. Invoice No.
20. 21.
Gift Returned Goods
Documents Commercial Sample Airmail
Merchandise Other: Surface
11. EEL/PFC 12. Restrictions
Quarantine Sanitary or Phytosanitary Inspection
13. I certify the particulars given in this customs declaration are correct. This item does not contain any dangerous article,
or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements
under the Foreign Trade Regulations. Sender’s Signature and Date
PS Form 2976-A, May 2009 PSN: 7530-01-000-9834 2 - Customs Declaration
United States Postal Service®
Customs Declaration and Dispatch Note — CP 72
IMPORTANT: This item may be opened officially. Please print in English, using blue or black ink, and press
firmly; you are making multiple copies. See Privacy Notice and Indemnity Coverage on Customer Copy.
14. Sender’s Customs Reference (If any)
15. Importer’s Reference - Optional (If any)
.
16. Importer's Telephone Fax Email (select one)
Sample
17. License No.
Sample
18. Certificate No.
19. Invoice No.
20. 21.
Gift Returned Goods
Documents Commercial Sample Airmail
Merchandise Other: Surface
11. EEL/PFC 12. Restrictions
Quarantine Sanitary or Phytosanitary Inspection
13. I certify the particulars given in this customs declaration are correct. This item does not contain any dangerous article,
or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements
under the Foreign Trade Regulations. Sender’s Signature and Date
PS Form 2976-A, May 2009 PSN: 7530-01-000-9834 3 - Customs Declaration
14. Sender’s Customs Reference (If any)
15. Importer’s Reference - Optional (If any)
16. Importer's Telephone Fax Email
Sample
Sample 19. Invoice No.
Gift Returned Goods
Documents Commercial Sample Airmail
Merchandise Other: Surface
11. EEL/PFC 12. Restrictions
Quarantine Sanitary or Phytosanitary Inspection
13. I certify the particulars given in this customs declaration are correct. This item does not contain any dangerous article,
or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements
under the Foreign Trade Regulations. Sender’s Signature and Date
PS Form 2976-A, May 2009 PSN: 7530-01-000-9834 4 - Dispatch Note
United States Postal Service®
Customs Declaration and Dispatch Note — CP 72
IMPORTANT: This item may be opened officially. Please print in English, using blue or black ink, and press
firmly; you are making multiple copies. See Privacy Notice and Indemnity Coverage on Customer Copy.
14. Sender’s Customs Reference (If any)
15. Importer’s Reference - Optional (If any)
.
16. Importer's Telephone Fax Email (select one)
Sample
17. License No.
Sample
18. Certificate No.
19. Invoice No.
20. 21.
Gift Returned Goods
Documents Commercial Sample Airmail
Merchandise Other: Surface
11. EEL/PFC 12. Restrictions
Quarantine Sanitary or Phytosanitary Inspection
13. I certify the particulars given in this customs declaration are correct. This item does not contain any dangerous article,
or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements
under the Foreign Trade Regulations. Sender’s Signature and Date
PS Form 2976-A, May 2009 PSN: 7530-01-000-9834 5 - Post Office Copy
United States Postal Service®
Customs Declaration and Dispatch Note — CP 72
IMPORTANT: This item may be opened officially. Please print in English, using blue or black ink, and press
firmly; you are making multiple copies. See Privacy Notice and Indemnity Coverage on Customer Copy.
14. Sender’s Customs Reference (If any)
15. Importer’s Reference - Optional (If any)
.
16. Importer's Telephone Fax Email (select one)
Sample
17. License No.
Sample
18. Certificate No.
19. Invoice No.
20. 21.
Gift Returned Goods
Documents Commercial Sample Airmail
Merchandise Other: Surface
11. EEL/PFC 12. Restrictions
Quarantine Sanitary or Phytosanitary Inspection
13. I certify the particulars given in this customs declaration are correct. This item does not contain any dangerous article,
or articles prohibited by legislation or by postal or customs regulations. I have met all applicable export filing requirements
under the Foreign Trade Regulations. Sender’s Signature and Date
PS Form 2976-A, May 2009 PSN: 7530-01-000-9834 6 - Sender’s Copy
IMPORTANT: Save this receipt and present it when making an inquiry.
PARCEL INDEMNITY COVERAGE: Indemnity for Priority Mail International® parcels, including insured and ordinary (uninsured) parcels, is provided only in
accordance with Postal Service regulations in the Domestic Mail Manual (DMM®) and the International Mail Manual (IMM®). The DMM and IMM are
available for inspection at any Post Office™ or online at http://pe.usps.gov/. The addressee must report damage or missing contents to the delivering Post
Office immediately.
Ordinary, i.e. uninsured, Priority Mail International parcels include indemnity coverage against loss, damage or missing contents. Indemnity is limited to the
lesser of the actual value of the contents or the maximum indemnity based on the weight of the article. The Priority Mail International Flat Rate Envelope and
Priority Mail International Small Flat Rate Box are letter post items and do not include indemnity coverage.
Insured mail service is available for a fee and replaces indemnity on ordinary parcels. Insurance coverage varies by country and is not available to some
countries. Indemnity coverage is subject to both U.S. Postal Service® regulations and the domestic regulations of the destination country. Insurance for loss,
damage, or missing contents covers the actual (depreciated) value of the contents.
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Claims for lost ordinary and insured parcels may be payable only to the sender, and claims for damage and missing contents may be payable only to the
addressee. The sender or addressee may waive the right of payment in favor of the other.
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FILING CLAIMS: To initiate an inquiry for loss, damage or missing contents, call the International Inquiry Center at 800-222-1811. International indemnity
inquiries and claims for loss must be filed within the time limits for the service purchased. All claims for damage or missing contents must be filed
immediately and the article, containers, packaging, and all contents received must be presented to the destination Post Office.
Evidence of mailing (e.g., original mailing receipts or wrapper), evidence of insurance, and evidence of value (e.g., sales receipt or repair estimate) must be
submitted in support of all claims. See IMM and Individual Country Listings for complete regulations at http://pe.usps.gov/.
EXCEPTIONS: No coverage is provided for consequential losses, delay, concealed damage, spoilage of perishable items, articles improperly packaged,
articles too fragile to withstand normal handling in the mails, or prohibited articles. See the DMM and the IMM for the specific types of losses that are
covered, the limitations on coverage, terms of insurance or indemnity and conditions of payment.
IMPORTANT: Indemnity coverage is not paid for Express Mail International or ordinary (uninsured) Priority Mail International parcels containing coins;
banknotes; currency notes (paper money); securities of any kind payable to the bearer; traveler’s checks; platinum, gold, silver (manufactured or not); precious
stones; jewelry, including watches; and other valuable or prohibited articles. See the IMM for complete regulations.
PRIVACY ACT STATEMENT: Your information will be used to satisfy reporting requirements for customs purposes. Collection is authorized by 39 U.S.C. 401,
403, 404, and 407; 13 U.S.C. 301 - 307; and 50 U.S.C. 1702. Providing this information is voluntary, but if not provided, we may not process your transaction.
We do not disclose your information to third parties without your consent, except to facilitate the transaction, to act on your behalf or request, or as legally
required. This includes the following limited circumstances: to a congressional office on your behalf; to financial entities regarding financial transaction issues;
to a USPS auditor; to entities, including law enforcement, as required by law or in legal proceedings; and to contractors and other entities aiding us to fulfill the
service (service providers); and to domestic and international customs pursuant to federal law and agreements, the U.S. Census Bureau, and other
governmental entities with authority over exportation.
PS Form 2976-A, May 2009 (Reverse of Page 6 of 6, Sender’s Copy) PSN: 7530-01-000-9834